Outcome of total elbow replacement for rheumatoid arthritis: Single surgeon's series with Souter-Strathclyde and Coonrad-Morrey prosthesis

BackgroundThe reported outcome of total elbow replacement is inferior to hip and knee arthroplasty, and there might be an element of institutional bias.MethodsWe analyzed the outcome of Souter and Coonrad-Morrey total elbow prosthesis in rheumatoid elbow performed by a single surgeon from a center independent from standpoint of being involved in the designing or manufacturing of the implant.ResultsWe had 44 Souter elbows with a mean follow-up of 108 months and 55 Coonrad-Morrey elbows with mean follow-up of 60 months. The Mayo Elbow Performance Score was comparable in both the groups with similar subjective satisfaction. Souter elbow showed a survivorship of 92.9% at 5 years and 76% at 10 years, with aseptic loosening rate of 18% and instability of 9% as main reasons for the failure. The Coonrad-Morrey elbow shows 100% survival at mean follow-up of 5 years in our series.ConclusionWe find high rate of instability and loosening of Souter prosthesis with an inferior 5-year survival compared to Coonrad-Morrey prosthesis.